Valvular & structural heart disease
Right Atrial Remodelling and Prognosis in Patients with Severe Atrial Functional Tricuspid Regurgitation
Authors' conclusion
RA and RV enlargement are poor prognostic factors in patients with severe AFTR. These findings underscore the importance of assessing RA and RV remodelling to optimize the timing of intervention in this population.
Study context
- Population
- Patients with severe atrial functional tricuspid regurgitation (AFTR)patients with severe AFTR, 96.1% of whom had atrial fibrillation
- Participants
- 155 patients
- Exposure
- Medical management group vs surgical intervention group
- Medical management groupn = 121
- Surgical intervention groupn = 34
- Outcome
- All-cause mortality
- Follow-up
- Median of 3.3 years
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Medical management group
34.7%
42 of 121
Adjusted hazard ratio (95% CI)P value
RV end-diastolic area index, per 1 cm²/m² increase
1.11(1.02–1.22)
P = 0.019RA area index, per 1 cm²/m² increase
1.06(1.02–1.10)
P = 0.006Per 1 cm²/m² increase, as printed
- Lower survival with RV end-diastolic area index >14.5 cm²/m² vs counterparts
- P = 0.012
- Lower survival with RA area index >22 cm²/m² vs counterparts
- P = 0.001
- Mortality highest with both high RV end-diastolic area index (>14.5 cm²/m²) and RA area index (>22 cm²/m²), lowest with low values for both
- P = 0.001
Observational data: associations, not effects.
Further findings
- Post-surgical deaths — surgical intervention group
- 11.8%
Post-surgical deaths
- Occurred exclusively in patients with both high RA area and RV end-diastolic area indices
Original publication
Right Atrial Remodelling and Prognosis in Patients with Severe Atrial Functional Tricuspid Regurgitation. ESC Heart Fail. Published 16 April 2025. doi:10.
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